This application requests continued support for the tri-institutional Medical Scientist Training Program (MSTP) at Stony Brook University, Cold Spring Harbor Laboratory and Brookhaven National Laboratory. Continuously supported by the NIGMS since 1992, our MSTP has almost a 40-year history of training physician-scientists, many of whom have gone on to make important discoveries and become leaders in biomedical research at academic medical centers across the country. Of our 111 graduates thus far, 43% are still in training, all in strong academic medical programs. Of the remaining graduates, 71% have academic faculty positions, many of which are highly prestigious, or are affiliated with university hospitals, NIH, or biotechnology / pharmaceutical groups, and another 11% are primarily clinical but contribute as educators and have academic connections. The goal of the program is to provide a rigorous training path that creates and fosters a physician-scientist mentality and a culture that imbues trainees with the tools, motivation, identity, and drive to pursue careers in academic medicine. Students are exposed to both clinical and basic scientific activities throughout their training, reinforcing the special nature of this program. Core courses unique to our MSTP include monthly seminar / dinners with both internal and external physician-scientist speakers, and a monthly journal club ? clinical pathological correlation dinner-evening that combines basic science with clinical applications in an active-learning manner. Our students participate in mini-courses in our unique Alan Alda Center for Communicating Science. PhD degrees are offered in a wide range of disciplines with the students being guided to undertake high-quality basic / translational science training to address problems relevant to human health. Since the last review, there have been many changes at SBU including (i) the recruitment of new MD and MD-PhD physician-scientists as Chairs of the major clinical departments and (iv) a $450M construction of a Cancer Center and Children?s Hospital. The MSTP has grown from 40 students 10 years ago to 58 at the last renewal and now 63, annual institutional support to the MSTP has correspondingly increased, the applicant pool size has remained stable, and both applicant and matriculant quality have increased substantially. In 2017/18, we matriculated 7 students (and we typically add another student from the existing medical school class). Many of our students hold individual NRSAs, publish high-impact articles, and have received a variety of honors, both intra- and extramurally. Overall time-to- graduation has averaged 8.05 years over the past decade. On average, MSTPs receive support for 25% of the funding years; in this application, we thus request that level of support, i.e. 16 lines. We are committed to the training of exceptional physician-scientists, which renewed funding will greatly facilitate.